The clinical relevance of serum antinuclear antibodies in Japanese patients with systemic sclerosis

Br J Dermatol. 2008 Mar;158(3):487-95. doi: 10.1111/j.1365-2133.2007.08392.x. Epub 2008 Jan 17.


Background: Systemic sclerosis (SSc) is a connective tissue disorder with excessive fibrosis of the skin and various internal organs. Although SSc is a heterogeneous disease, it has been reported that the particular antinuclear antibodies (ANA) are often indicative of clinical features, disease course and overall severity.

Objective: To clarify the association of clinical and prognostic features with serum ANA in Japanese patients with SSc.

Methods: We studied 203 Japanese patients diagnosed with SSc, who visited our hospital during the period 1983-2005. Six SSc-related ANA were identified using indirect immunofluorescence, double immunodiffusion and immunoprecipitation assays.

Results: Patients with SSc were classified into six ANA-based subgroups and a group without ANA. As expected, antitopoisomerase I antibody (Ab, n=64), anti-RNA polymerases (RNAP) Ab (n=12) and anti-U3 RNP Ab (n=5) were associated with diffuse cutaneous SSc, whereas anticentromere Ab (ACA, n=75), anti-Th/To Ab (n=7) and anti-U1 RNP Ab (n=10) were frequently detected in patients with limited cutaneous SSc. Clinical features of the ANA-negative group (n=10) were heterogeneous. Consistent with previous findings in Caucasian and/or black African patients, antitopoisomerase I Ab was associated with the involvement of vascular and pulmonary fibrosis, leading to decreased survival rate. However, no patients with anti-RNAP Ab developed renal crisis and the frequency of isolated pulmonary hypertension in patients with ACA, anti-Th/To Ab or anti-U3 RNP Ab was similar to that in other ANA-based subgroups.

Conclusion: These results indicate that the clinical relevance of SSc-related ANA in Japanese patients differs in some aspects from that in Caucasian and/or black African patients.

MeSH terms

  • Antibodies, Antinuclear / analysis
  • Antibodies, Antinuclear / genetics*
  • Antibodies, Antinuclear / immunology
  • Asian Continental Ancestry Group / ethnology
  • Cause of Death
  • DNA Topoisomerases, Type I / analysis
  • DNA Topoisomerases, Type I / genetics*
  • Female
  • Fibrosis
  • Humans
  • Japan / ethnology
  • Male
  • Middle Aged
  • Scleroderma, Systemic / drug therapy
  • Scleroderma, Systemic / immunology*
  • Survival Rate


  • Antibodies, Antinuclear
  • DNA Topoisomerases, Type I